GPs step up as Melbourne locks down

Doug Hendrie

6/07/2020 3:11:53 PM

With anxiety and distress spiking in suburbs plunged back into lockdown, GPs are answering the call to help in any way they can.

Isolated patient on the phone
Glenroy GP Dr Fady Abdou’s clinic has been running a reach-out call service, actively contacting patients about whom staff are concerned.

For Glenroy GP Dr Fady Abdou, stepping up to help means setting up a check-in phone service to make contact with isolated and anxious patients – and even suggesting possible job options.
‘If you can offer support – even if it’s not medical – you are doing your job as a GP,’ he told newsGP.
‘Supporting your community is part of general practice.’
Glenroy, about 13 km north of Melbourne, has been locked down for almost a week, triggering a new wave of mental health issues.
Much of the anxiety is tied up with job losses and concerns over finances.
‘Lots of my patients are overseas students who have relied on part-time jobs in hospitality or driving Ubers,’ Dr Abdou said. ‘Now they’re out of jobs and there’s no income for them. Many are now coming down with anxiety and panic attacks.
‘They are stuck here – they cannot go back home. They are struggling with rent and need me to write support letters for real estate agents or the owner, so they can pay the rent after they get a job.’
In response to the community’s growing needs, Dr Abdou’s clinic has been running a reach-out call service, actively contacting patients about whom staff are concerned.
‘We call them, offer a check for flu-like symptoms, encourage them to do a swab, and then check on their mental health,’ Dr Abdou explained.
‘I have found these [calls] are quite helpful, as many of these patients really need someone to reach out. They just need someone to call them and to tell them there are supports there if they need to [access them].’
For casual workers who have lost their jobs and are ineligible for JobKeeper, Dr Abdou has even suggested possible jobs in sectors experiencing growth during the pandemic, such as grocery delivery or supermarket shelf-stacking.
‘Older people are affected mentally and physically as well, as they cannot leave their houses and many find it hard to do telehealth,’ he said. 
Many of Dr Abdou’s patients were unaware they could undertake mental health care plans over telehealth.
Melbourne has now locked down 12 postcodes, most recently expanding to Flemington, Kensington and North Melbourne. The CBD – which is seeing cases increase – may be next.
Australia has seen a doubling of mental health issues in the wake of the nationwide lockdown, according to a large survey of almost 14,000 people published in the Medical Journal of Australia.  
Monash University Professor of Public Health Jane Fisher told the ABC it is normal to have around 5% of people with severe low mood. However, the survey found 25% of people reported moderate to severe depression, with young people aged 18–29 experiencing the highest rates of depressive symptoms at a staggering 45%.
The Black Dog Institute has warned that people who are unemployed and casualised are at increased risk of worse mental health during a pandemic.
‘High job insecurity is associated with stress, financial strain, poorer health and increased rates of depression and anxiety,’ the organisation warns.
Influential mental health advocate Professor Patrick McGorry has previously predicted the mental health consequences of the lockdown will be like a ‘second wave of the epidemic’.

Local residents can be unnerved by the regular presence of health authorities in locked down suburbs. (Image: AAP)

These predictions come as no surprise to Dr Dora Shirin, a GP in Craigieburn, a locked down suburb on Melbourne’s northern fringe. Every day, her patients are reporting worry, stress and worsening mental health.
‘We have had the frustration of a long period of lockdown, a little bit of time released, and then lockdown again. People are uncertain – they’re not sure if it will get better after a month,’ she told newsGP.
‘This kind of lockdown puts too much strain on their minds.’  
Dr Shirin’s patient load has decreased markedly, as people stay away – even from telehealth.
‘We aren’t seeing a lot of community transfer here. People are very cautious. There is a lot of community awareness,’ she said.
‘We have to give it time, make people comfortable, give positive reassurance and comfort.

‘It’s a very difficult situation, with the uncertainty, fear and not knowing the future. People don’t know how long they will be locked down.’
Dr Shirin has not yet seen the emotional and mental fallout from job losses in her community.
‘Because JobKeeper is still going. We haven’t seen much economic worry or stress,’ she said.
‘But that may change after September.’
Broadmeadows GP Dr Mariam Tokhi recently described a worse situation among patients in The Guardian.
‘Dominic hasn’t been eating well because he has no money after paying for his daughter’s specialist appointment. Mary was in tears today because her housemate attempted suicide at the weekend. Ahmed is a refugee living in limbo on a temporary visa. Hala has lost her job at the factory, again,’ she wrote.
‘As local industries have collapsed, poverty levels have increased. Unemployment levels are high.
‘Poverty begets illness, and illness begets poverty. And so my patients come in telling me stories of misfortune and pain, their bodies ailing with high blood pressure, diabetes, mental illness, drug dependence, pain and trauma.
‘Most are kind, ordinary, family-oriented people who are battling to survive among higher levels of financial and social stress.’
But Dr Tokhi also observes that her area is one with ‘incredible strength and survivorship’.
‘There is a trope circulating that people from Broadmeadows don’t care about health – I’ve found the opposite is true,’ she said.
‘They come into the clinic, beseeching us for compassionate care.
‘Everyone wants to live well, and live long.’
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Dr Elizabeth Dorothy Hindmarsh   7/07/2020 9:18:07 AM

Thank you to all the GPs doing such a great job of keeping in touch with your patients. Hoping you are also getting support and keeping emotionally as well as physically well.

Dr Chong Yen Pau   7/07/2020 9:33:04 AM

This is a very good approach lockdown periods during pandemic.

Dr Magdalena Simonis   11/07/2020 7:08:52 AM

Well done on your work and kindness. Thankfully with Teleheath we have the ability to continue to support our isolated and vulnerable patients. Many international students don’t have medicare, are stuck, alone, without family. Keeping in touch by phone ( no charge of course) makes a bit of a difference I’m told. Even though I feel utterly powerless. In the city, where I am based I see many students. I just keep thinking, ‘they're the same age as my own children’.

Dr Seema Sharma   11/07/2020 1:41:58 PM

Hats off to all Melbourne GPs for their hard work and dedication in looking after their patients’ mental and physical ailments during this epidemic. It must be taking a tremendous personal toll upon you and your families; we are all thinking about you .. Is there anything your interstate GP colleagues can do to support you?